INTRODUCTION
“We are continually faced by great opportunities brilliantly disguised as insoluble problems.” Lee Iacocca
In late 2007 and early 2008 the delivery of primary health care on Gabriola Island, BC, had reached a crisis point. The community had developed an emergency or urgent care treatment room to facilitate the provision of urgent medical care on the Island (the “UCR”), and only two physicians were offering on-call services. The result was that they were working excessive hours. In addition, a province wide review of the Medical On-Call Availability Program (“MOCAP”), and resulting moratorium of MOCAP by VIHA, meant that Gabriola physicians performing the on-call duties were not being compensated for the services being rendered. The situation became unsustainable.
As a result, in early 2008 representatives of the Gabriola Health Care Society (“GHCS”), the Gabriola Professional Centre, the British Columbia Ministry of Health (“MoH”), and the Vancouver Island Health Authority (“VIHA”) met on number of occasions to discuss the delivery of health care on Gabriola Island, and steps that could be taken to improve that delivery. One of the results of the series of meetings was a Memorandum of Understanding (the “MOU”) between the parties referred to above. One requirement under the MOU was that GHCS, in conjunction with the MOH and VIHA, initiate a process to plan for the future delivery of health care on Gabriola. The MOU set out the following criteria for the process and the resulting report:
1. There was to be an open invitation to:
(a) all residents of Gabriola
(b) all Gabriola physicians with patients on Gabriola,
(c) other health care providers from ambulance service, home and community care, for example, and
(d) VIHA and the MOH
to be involved in a planning process that utilized methods such as surveys or town hall meetings.
2. The resulting plan must:
(a) provide for working hours for physicians that are sustainable and support and maintain the health and wellbeing of the physicians,
(b) be based upon population based data, evidence, resident and provider experience,
(c) benefit Gabriola by building upon the current investments and programs in primary health care and physician remuneration, and
(d) include indicators important to the residents and providers on Gabriola to measure progress and success.
As a result a facilitated public workshop was held on Gabriola on June 20, 2008. In addition the GHCS set up an internet blog that enabled Islanders who could not attend the workshop to add their comments on the predefined afternoon topics.
This report has been prepared to:
1. draw together the comments provided by those attending the workshop and the comments entered into the internet blog, and
2. set out:
(a) a series of community goals extracted from those comments,
(b) the steps that can reasonably be taken by the community to work toward achieving those goals,
(c) the agreed priorities, and
(d) those responsible for each of the steps, as agreed to by those responsible.